Proposed Senate Bill Would End Obamacare Medicaid Expansion Nationwide
Last month, a trio of U.S. senators released their version of an Obamacare replacement bill, which they called the Patient Choice, Affordability, Responsibility, and Empowerment Act (Patient CARE Act). The legislation would initiate a host of changes to how health care is delivered in the United States . . . and that includes a wholesale rollback of Obamacare's Medicaid expansion.
According to the Center for Health and Economy,
The federal funding for the Medicaid expansion provided by the ACA is no longer available under the Patient CARE Act. Additionally, the current Medicaid funding mechanism will be replaced with capped, per-beneficiary allotments that are indexed to inflation. States will receive pass-through grants for certain high-risk populations and defined budgets for long-term and elderly care.
Translation? In many respects, Medicaid would return to its intended focus of assisting those in poverty—that is, those at and below the federal poverty level—rather than those above the poverty line. That's extraordinarily important. Obamacare's Medicaid program basically makes able-bodied, childless adults not in poverty a federally preferred class of beneficiaries, with the federal government paying a greater share of the cost for many adults above the poverty line (90/10 federal to state) than it does for all sorts of beneficiaries below it (roughly 60/40).
Are adults between 100 percent and 133 percent of the federal poverty level rich? No. Are they in poverty? Also no, by definition.
Keep in mind, too, that the Patient CARE Act is only one of many proposed overhauls of the country's health care system. All of its provisions, as well as the provisions of competing reform legislation, need to be debated on their merits in the weeks and months ahead. (We have our own ideas for key reforms of our health care system, of course.)
Make no mistake: Taxpayers have every right to be skeptical of the federal commitment to fully fund its portion of the Medicaid expansion indefinitely as the government swims in trillions of dollars of fresh debt. As the unsustainable fiscal realities of the Medicaid program and this Obamacare alternative both demonstrate, taxpayer skepticism of the expansion's future is fully warranted.
View the original at Show-Me Institute →
As confirmed against the Show-Me Institute's website on August 15, 2026, the Institute's stated policy permits reprinting of its published articles and commentary provided the original author receives credit. Letting the Institute know about a reprint is appreciated but is not a condition of use.
This entry was archived under that permission as it stood on the date above. If the Institute's policy changes after that date, it does not apply retroactively to entries already reproduced here under the terms in effect at the time — this is a record of the grant as confirmed, not a live status check.
The original remains hosted at the Institute's own site — use the link below for the canonical version, current formatting, and any images.